Employees at Hypertherm in Hanover use a company workout room. (COURTESY)

Wellness programs aim to balance employee health and company costs

By MELANIE PLENDASpecial to The Union Leader

A checkup with a nurse practitioner, a lunch full of freshly-grown veggies and a pickup game of basketball - all in a day's work for some as more Granite State employers attempt to integrate wellness into the workday.

Firms across the state are ditching junk food, going smoke-free, installing gyms and even opening clinics on site with an eye towards bettering the health of their workers. While good, the intentions are not entirely altruistic since healthy employees means higher production, lower medical insurance costs for employers and fewer absences from work.

"You used to hear a lot about a happy associate is a productive associate," said Deane Ilukowicz, vice president of Human Resources for Hypertherm in Hanover. "And really the logic is switched. If you're productive, you feel like you are adding value at work, that's going to create higher engagement. It's going to motivate you more. So we really focus on providing the very best environment for our associates."

It is costly for companies to insure sick people, and it's getting costlier.

A recent study issued by The MetLife Mature Market Institute and Center for Health Aging estimates that obesity alone will increase expenditures by roughly $1,723 per year per capita. That will make the annual medical burden nearly 8.5 percent of total annual expenditures, according to the study.

And America seems to be careening toward that cliff since the same study reports that more than one in four Americans age 18 and older are obese, three in 10 adults have high blood pressure and roughly one in 10 have diabetes.

Further, loss of production costs a company on average twice as much (2.3 to 1) as medical and pharmacy costs alone, according to a 2009 study published in the Journal of Occupational & Environmental Medicine.

"Employers have seen the cost of health care rise, and that's attributable to everything from obesity to drugs and alcohol to smoking, and other lifestyle issues," said James P. Reidy, a labor attorney with Sheehan, Phinney, Bass and Green. "That's why insurance companies responded, gosh 10 years ago with, 'If you go to the gym X number of times, you'll get this rebate' and so on."

That was in part the impetus for Hypertherm's wellness program.

In 2009, the company, in conjunction with Dartmouth Hitchcock Medical Center, launched The Hypertherm Associates Wellness Center, a clinic staffed with a physician assistant and a registered nurse right on campus. It was so popular, the company has since opened a second clinic.

"From a cost perspective, though, the cost of an associate going to our wellness center versus getting in their car and going to the emergency room, where something could likely be treated in our environment, is much less expensive for the company," Ilukowicz said. "The other thing it saves (associates) is time."

For example, if an employee gets strep throat and takes the time to make an off-campus appointment, drive to the doctor, wait for the doctor, all for something that could have been treated on campus "I not only incur more cost to myself and to the company, but I also lost a lot of productive time," Ilukowicz said.

In addition to the wellness centers, the company also has an onsite gym, basketball courts and a community garden where organic veggies are grown for the cafeteria.

Recently the facility has also gone smoke-free, with smokers having to leave the campus to smoke. Employees get a discount on health insurance if they quit smoking. Further, the company implemented voluntary biometric screenings for both employees and their families. These screenings check height, weight, cholesterol, blood pressure and blood sugar. The results of these screenings are used, where necessary, to create a wellness program for employees if they would like one. For those who embark on a weight-loss program, they can earn small cash prizes and rewards.

To further help employees with wellness, the company hired a full-time wellness manager and allowed employees access to online health coaching through their health insurer Cigna. While all of this is voluntary, the wellness coordinator does occasionally select people to offer further assistance when it comes to weight or smoking, for example. Ilukowicz said the manager will offer assistance if she sees someone smoking or if someone who is overweight appears to be struggling.

"That can be a difficult conversation to have," she said. "But she has a such a personality that she will find a way."

Ilukowicz was adamant that none of this information is shared with officials at the company and that Cigna, the wellness center physician assistant and the wellness manager all have to have an employee's consent to talk to each other.

The potential of sharing biometric information made headlines recently when CVS Pharmacy decided all employees had to get their biometrics taken and report them to the insurance company or face a $50 per month fine. Critics of this policy believe it to be coercion and fear that it could lead to sick people getting fired.

"The law is basically this," Reidy said. "If you create an incentive, you're fine. If you create a penalty, you're not. And that's really it."

And while most companies have not gone to the lengths of Hypertherm, many are implementing wellness initiatives. Officials at Vital Design in Portsmouth, for example, built a gym hour into the workday. So twice a week, all of the employees go together to a local fitness club and play sports or take a class together for an hour or so.

The Merrimack Branch of the YMCA of Greater Nashua hired a personal trainer/coach for its employees who helped them establish a wellness goal - be it physical, mental or emotional wellness - that they could each reach by May.

Dick Olson, chief financial officer for YMCA, said he set a goal of losing 25 pounds and gaining strength. So far, he said, he's already lost 15 pounds, and isn't done yet. And while he said he's the type who's always tried to get fit on his own in the past, he found the support - online with encouraging emails - and in person with training sessions, to be a big part of his success.

While many good things can come from these types of programs, companies do need to be careful, Reidy said. Businesses can get too close to crossing the line. By way of example, he said, he's had clients who want to charge smokers or people with a certain body mass index, more for health insurance.

"I think the legal arguments you run into are you are discriminating essentially?" he said.

"And people who are morbidly obese are protected under federal and state disability laws. Smokers are protected under state law. The question is where you draw the line? If you eat a Twinkie are you on a list? If you have an occasional French fry? You know? And some people, they are just built differently than others."